OUR VIEW: Preventing a vicious cycle of pain

Tuesday

Mar 12, 2013 at 12:01 AMMar 12, 2013 at 12:22 PM

The very pharmaceuticals intended to relieve pain in patients with severe maladies can create a vicious cycle of pain to patients’ families and the community as a whole. When addiciton takes hold, the problem can manifest itself in broken lives and addiction-fueled acts of crime that plague Fall River and communities large and small.

Officials are hoping to address the issue both through legislation and federal regulations. The action being requested by the attorneys general is similar to legislation introduced two years in a row by U.S. Rep. William Keating. Keating, a former district attorney who crafted the legislation, plans to further push for his bipartisan legislation at an announcement in Washington on Friday. The Stop Tampering of Prescription Pills Act of 2013 (or STOPP Act), as it’s known, would create a system of incentives and regulations to achieve the goal for both extended- and immediate-relief formulations of painkillers.

The very pharmaceuticals intended to relieve pain in patients with severe maladies can create a vicious cycle of pain for patients’ families and the community as a whole. When addiciton takes hold, the problem can manifest itself in broken lives and addiction-fueled acts of crime that plague Fall River and communities large and small.

Massachusetts Attorney General Martha Coakley and Rhode Island Attorney General Peter Kilmartin are among 48 attorneys general who, in a letter from the National Association of Attorneys General Monday, called on the Food and Drug Administration to enact new regulations requiring makers of generic pharmaceuticals to create tamper- and abuse-resistant versions of opioid-based prescription painkillers to prevent abuse, illegal trafficking and overdoses.

Officials are hoping to address the issue through legislation and federal regulations. The action being requested by the attorneys general is similar to legislation introduced two years in a row by U.S. Rep. William Keating. Keating, a former district attorney who crafted the legislation, plans to further push for his bipartisan legislation at an announcement in Washington on Friday. The Stop Tampering of Prescription Pills Act of 2013 (or STOPP Act) would create a system of incentives and regulations to achieve the goal for both extended- and immediate-relief formulations of painkillers.

“We need to fight to remove the stigma associated with prescription drug abuse and provide better education and resources,” Keating said. “But all of that could be for naught without properly regulating these addictive painkillers. The STOPP Act will make tamper-resistant painkillers the norm, not the anomaly. This alone will not solve the problem, but it’s a proactive step in the right direction that might save hundreds of lives across the country.”

Keating’s legislation would require brand-name companies to develop formulas for pills containing oxycodone and hydrocodone that cannot be crushed — as is the case with the brand name Oxycontin — or even developing formulas that can detect when a person has taken too many pills and bring down the potency of the pill. Recent evidence from West Virginia — where there is a high rate of opioid abuse — indicates that tamper- and abuse-resistant formulas have dropped the street value and availability of illegally trafficked Oxycontin.

Under the STOPP Act, the secretary of Health and Human Services would specify, on a case-by-case basis, a time period for drug manufacturers to start using a tamper-resistant formulation. If the drug company misses the deadline, the drug would be taken from marketing due to safety reasons. Generic drugs would follow a similar model.

According to Keating, this action needs to be taken soon. In April, the FDA is expected to allow generic pharmaceutical companies to begin manufacturing and selling a generic version of Oxycontin, the highly potent and dangerous pain reliever. While Oxycontin’s brand name manufacturer voluntarily released tamper- and abuse-resistant pills several years ago, the much less expensive generics expected to soon flood the market will not contain those formulas. That will make the pills easily accessible, inexpensive and easy for those not prescribed the drug to tamper with and abuse.

Addiction to powerful and frequently prescribed painkillers has become an increasingly troubling problem. According to Keating, the Centers for Disease Control and Prevention deems prescription drug abuse to be an epidemic that claims more than 15,500 American lives, costing more than $70 billion each year. In Massachusetts, the congressman said, nearly two people die each day due to opioid overdoses.

Here in Bristol County, the problem is especially acute. According to Keating, Bristol County has the highest rate of opioid abuse in the state. Another area of Keating’s district, Barnstable County — on Cape Cod — has the second highest rate of abuse. Recent studies indicate that more people die nationwide from prescription opioids than cocaine and heroin combined.

People who have never struggled with drug addiction can become trapped in a cycle of addiction after being prescribed such pain relievers. Some patients who are prescribed these medications also end up selling them. Opioid-based painkillers can cause some people prescribed such medications for pain to seek even more powerful drugs, such as heroin.

Keating’s STOPP Act legislation has been referred to the House Energy and Commerce Committee, but it does not yet have a sponsor in the Senate. It is beyond time for federal officials to address the prescription drug abuse epidemic that is plaguing communities nationwide. Whether achieved through new FDA regulations, Keating’s legislation or both, such efforts to stymie prescription drug abuse could go a long way in preventing the escalating cycle of drug abuse.